I'm getting to the point where I'm not sure what to do, and I am very frustrated.
For the last 6 months or so, it seems I cannot get my morning number under 220, and it feels as though I am becomming a lot less sensitive to insulin. My basals have gone from 24 units per day to 34. My carb ratio has gone from 1:9 to 1:5, and my correction is about 1:30. I'm running 16 units of Levemir at 8 am, and 18 units at 11pm. My basal feels right, as it runs even though out the day. And if I go to bed at at 120, around 3am, I'll still be in that range, but by 7am I'm in the mid 200s.
I've started checking everynight in the middle of the night, but it doesn't seem to help. Its like my body is pumping out sugar to match my insulin intake. I've checked at 5am, it will be 220, 100 points higher than my bed-time number, I'll take 3 units, and at 8am, I'll be 205, as if the 3 units did nothing.
I'm out of ideas. I thought about maybe when I wake in the middle of the night, taking 2 units, and a tablespoon of peanut butter to try and curb the starving aspect.
Anyways, any thoughts?
Jason-Because I use a pump I have never added NPH to an MDI regimen. I used to be on NPH before I used Lantus.
I frankly think you will need to experiment and probably start by replacing some of your basal with the NPH. Since you take some of your Levemir at 11:00PM, I would replace some of that with NPH. Be conservative and see what happens.
Hopefully someone who has done this will chime in with some suggestions.
First of all, I LOVE your avator, Jason!
Pump is a great idea, as always. One of the best pieces of advice I ever got on TU is to consider when you take insulin to counteract a high. If I am waking up at 220 every morning at 7am, I would up my basals starting around 3:00 am, as it acts over a 4 hour time span. But with Levemir, I am not familiar.
Even with a pump, I set an alarm every night for 1 am, test and go from there. If I were you, I would set one 4 hours back from wake up and start to ascertain when the glucose levels begin to rise. You may need to bolus overnight to counteract this.
Dawn phenom? Good luck and let us know how it goes.